Emerging Interventions to Improve Health Outcomes for People Aging With HIV: Protocol for a Mixed Methods Implementation Science Evaluation

Abstract

Background: In 2022, 54% of people with HIV were aged 50 years and older; however, clinical care for HIV in the United States often falls short of comprehensively integrating care for aging-related conditions. In response, the Health Resources and Services Administration HIV/AIDS Bureau Ryan White HIV/AIDS Program funded a new initiative comprising 10 demonstration sites to test emerging interventions to support people aging with HIV, as well as a capacity-building provider and an evaluation provider. NORC at the University of Chicago received an award for the evaluation provider.

Objective: This protocol aimed to describe the application of the Health Resources and Services Administration HIV/AIDS Bureau implementation science (IS) framework to a multisite evaluation, a related evaluation protocol, the technical assistance provided to support the evaluation, and the initiative's dissemination plan.

Methods: Using a theory-based approach, NORC developed a mixed methods evaluation plan using an IS hybrid type 2 study with two main aims: (1) to describe implementation outcomes and (2) to assess client-level outcomes. Implementation outcomes were assessed at the organizational level using tools including a survey of site characteristics, key informant interviews, and documentation of monthly monitoring calls and costs. Client-level outcomes were assessed through a survey and a medical chart abstraction tool. NORC also collected data on the sites' engagement with the capacity-building provider and their satisfaction with the services provided.

Results: The evaluation was funded in August 2022. Organizational-level data collection began upon institutional review board approval in April 2023. All sites were enrolling clients in the intervention and evaluation by September 2023, and 626 clients enrolled by December 2023. Data collection is expected to continue through December 2024. Analysis of the baseline results is currently underway, and comprehensive findings are expected by late 2025.

Conclusions: To the best of our knowledge, this is the first national study to evaluate emerging clinical interventions for people aging with HIV using an IS framework. The findings will build an evidence base for advancing HIV clinical care to meet the needs of the aging population.

International registered report identifier (irrid): DERR1-10.2196/72471.

Keywords: HIV and aging; emerging interventions; evaluation; geriatric care; implementation science.